Excimer Laser-Assisted Nonocclusive Anastomosis

Excimer laser-assisted non-occlusive anastomosis, or ELANA, is a neurosurgical technique used to create a bypass without interrupting the patient's blood supply, first developed in 1993. Unlike conventional bypass techniques that temporarily stop blood flow with clips before opening an artery with scissors or a scalpel, ELANA uses a 308 nanometer excimer laser delivered through a catheter inserted into the chosen blood vessel, maintaining continuous circulation and protecting brain tissue from ischemic damage. The technique applies to bypasses connecting major cerebral arteries, including extracranial-to-intracranial and intracranial-to-intracranial configurations, and sutureless modifications have extended it to cardiac surgery.